The first column lists the authors in red, and their claimed peer reviewers in green. The third column lists the anti-fluoride organisations and several publications these people are connected to.

The middle column lists some other people who are also connected to these organisations and publications. I have already reviewed Kathleen Theissen’s article (see Peer review of an anti-fluoride “peer review”) and will get around to reviewing the other 2 articles (by H.S. Miclen and Stan Litras) later.

Meanwhile, lets just consider the connections between these authors, “peer reviewers” and anti-fluoride organisations.

Taking in each other’s laundry

Most of these names are familiar to anyone who has followed the anti-fluoride movement. That fact in itself shows how this report can in no way be seen as “expert,” “independent” or at all credible. Some details on the illustrated people, organisations and publications.

NRC Review minority: There were several disagreements on the 12 member panel which produce the 2006 NRC report “Fluoride in drinking water. A scientific review of EPA’s standards” because 3 members were anti-fluoride. They were Robert Issacson, Hardy Limeback and Kathleen Theissen. Hardy Limeback is involved in several anti-fluoride activist groups.

Kathleen Theissen appears not to be organisationally involved but regularly makes anti-fluoridation submissions when the issue is debated.

UPDATE: Steve Slott has reminded me of this example of Theissen’s lack of credibility as a peer reviewer of fluoridation-related papers:

“In July 2013, Douglas Main, that freelance reporter and bastion of “objectivity”, interviewed Thiessen to get her opinion on Hirzy’s study on which he based his petition to the EPA.

“I think this is a reasonable study, and that they haven’t inflated anything,” said Kathleen Thiessen, a senior scientist at SENES Oak Ridge Inc., a health and environmental risk assessment company.”

When the EPA reviewers looked at Hirzy’s study they found that he had made a 70-fold miscalculation in his study. When corrected for that error, the EPA reviewers found that Hirzy’s data actually demonstrated the exact opposite of what he had concluded.

Seems Thiessen either didn’t bother to read Hirzy”s study prior to commenting on it, or she overlooked his glaring error, too.”

Fluoride/ISFR: The International Society for Fluoride Reasearch (ISFR) publishes the journal Fluoride and organises regular conferences. They provide an avenue for authors to publish anti-fluoride articles, and generally poor quality research from areas where endemic fluorosis is common which may not be acceptable in the normal scientific journal.

The Society is based in New Zealand and is registered here as a charity. Bruce Spittle is the treasurer and journal managing editor.

FTRC/Second look: The anti-fluoride organisation and web site Second Look as set up the Fluoride Toxicity Research Collaborative (FTRC). It appears to be a weak attempt to provide a front “scientific institute” for anti-fluoride activists who want to present themselves as scientific experts.

This reminds me of the creationist Biologic Institute set up by the intelligent design creationists at the Discovery Institute. Actually, the Intelligent Design “pretend” scientific journal Bio-complexity also reminds me of the anti-fluoride journal Fluoride.

The senior author Anna Strunecká is also part of the anti-fluoride network illustrated above. I am personally very suspicious of the quality of the journal which published this paper – anti-fluoride people have a history of placing poor quality papers in suspect journals purely to attain some sort of scientific credibility.

NZ Tour of Don Quixote & Sancho Panza: Sorry, can’t help thinking of these two when the upcoming NZ tour of Paul Connett and Bill Hirzy is mentioned. They do seem to be charging local fluoridation windmills with meetings in Taupo and Auckland.

The “credibility” of his “expertise” on the subject is shown by the fact his second paper was necessary to correct the huge arithmetic mistake he made in the first paper!

Perhaps you can see why the Connett/Hirzy act brings Done Quixote and Sancho Panza to my mind.

Conclusion

The “report” is discredited even before addressing the arguments presented – simply because of the well-known anti-fluoride stance of all the authors and “peer-reviewers.” The diagrammatic network shows just how incestuous the “report” is. It is simply an attempt to put a “sciency” face on their political stand and their attack on the Royal Society Review.

“I have already reviewed Kathleen Theissen’s article (see Peer review of an anti-fluoride “peer review”) and will get around to reviewing the other 2 articles (by H.S. Miclen and Stan Litras) later.”

Yes I have read the material – and will comment on 2 of the articles soon. However, my analysis of Kathleen Tiessen’s article (and Chris Neurath’s which was in the original draft) is at Peer review of an anti-fluoride “peer review”. You are welcome to read and comment on it there.

So, something for you to go on with and look forward to. I know you enjoy may analyses of this sort of material. 🙂

Oh, this is truly comical. It’s like Laurel and Hardy being peer-reviewed by the Keystone Kops. Well, you gotta given them some slack, Ken. When there are only a small handful of fluoride opponents in the world who have any semblance of respect attached to their names, they have to constantly be recycled and trotted out as the “lots of scientists that oppose fluoridation”.

Here’s an example of Thiessen’s credibility. In July 2013, Douglas Main, that freelance reporter and bastion of “objectivity”, interviewed Thiessen to get her opinion on Hirzy’s study on which he based his petitition to the EPA.

From the article:
“Experts not involved with Hirzy’s study agreed with its findings.”

“I think this is a reasonable study, and that they haven’t inflated anything,” said Kathleen Thiessen, a senior scientist at SENES Oak Ridge Inc., a health and environmental risk assessment company.”

When the EPA reviewers looked at Hirzy’s study they found that he had made a 70-fold miscalculation in his study. When corrected for that error, the EPA reviewers found that Hirzy’s data actually demonstrated the exact opposite of what he had concluded.

Seems Thiessen either didn’t bother to read Hirzy”s study prior to commenting on it, or she overlooked his glaring error, too.

In that “report”, Stan Litras accuses Martin Lee and Peter Dennison of “cherrypicking” the evidence by using just Canterbury and Wellington data in their 2004 paper. If he actually knew what he was talking about, he would be aware that, at that time, those were the only two services collecting electronic unit record data on children, thus allowing multivariate analysis. No other service in the country was doing it then. Perhaps he does know and is being disingenuous…

Thanks for the reminder Steve. I am afraid I was suffering some early seasonal fatigue and missed that. I will update the article and diagram to bring that fact out – it is important as the Fluoride Free people are relying on her skills as a peer reviewer.

Now, Shane, getting back to the content of my article and away from your attempted diversion. It appears you have just had to accept my statement that the FF report is a farce prepared by an incestuous group ain’t-fluoride activists while regularly Take in each other’s laundry.

Why else would you attempt to divert attention away from the conetent of my article?

In an ideal world, antifluoridationists would be reasonable people truly interested in protecting the public against what they believe to be dangers to the health and well-being of that public. They would be intelligent enough to understand the limitations of their knowledge, understand that they do not know more than highly educated and experienced healthcare experts, and open to learning the facts. When presented with the reasons why their beliefs were erroneous, instead of scurrying around to fabricate their own set of “facts”, they would explore and verify the validity of those reasons, and then begin to understand that it is their beliefs that are in error, not the facts. They would accept that the facts are not the product of conspiracy and corruption, but are simply the facts supported by valid evidence. They may still oppose fluoridation, but willing to admit that this opposition is ideology driven, not anything grounded in science.

“It is important to note that it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be considered a fluoridation study as such. The following results are for a snapshot in time and constitute an ecological analysis based on current place of residence. As such, they do not take into consideration lifetime exposure to fluoridated and nonfluoridated water supplies. Individuals who currently live in fluoridated areas may have spent time in non-fluoridated areas, and the reverse is also true. Furthermore, there may be other confounding facts that have not been taken into consideration.” Our Oral Health Page 167

Given the above statement in Oral Health report do you believe that it was disingenuous for DHBs to use the 40% tooth decay reduction figure from the 2009 Oral Health Survey for the difference between fluoridated and nonfluoridated areas?

As you will be aware this was a key plank of the 2013 referendum’s in Whakatane, Hastings and Hamilton.

Otago Dental School researchers obtain research funding from a variety of sources, including the Health Research Council, the Ministry of Health, the NZDA Research Foundation, the Maurice and Phyllis Paykel Trust, Lottery Health, etc – this is all competed for in the public domain (and funding sources are acknowledged on any paper which is published). Contrast this with the mysteriously well-funded anti-fluoride lobby…. perhaps someone might like to enlighten us on their sources of funding and how funding is obtained?

Good question, Murray. Probably the most blatant conflict of interest is Paul Connett’s “Fluoride Action Network”. In contrast to healthcare organizations which support water fluoridation as but one aspect of overall science and healthcare concerns they view as beneficial, “FAN” exists solely to oppose water fluoridation. It’s entire income and very existence is completely dependent on its ability to keep the fluoride issue alive and create “controversy” over fluoridation where none exists. Without this issue, “FAN” would presumably cease to exist, its $150k yearly budget dried up, income for Connett and his family gone, and whatever travel expenses “FAN” may fund for Connett’s travels all over the US, Australia, NZ, Europe, and wherever else he elects to travel supposedly for purposes of opposing fluoridation, gone as well.

Can you please explain why in your own study also mentioned in the review. It claimed in the summary that decay was halved by water fluoridation, but stated in the paper that they found no difference based on fluoridation status.

Do you concede that the NZ Review’s claim of “a shift of less than one IQ point” in the 27 studies reviewed by Choi et al (2012) was incorrect and in reality, the average lowering of IQ was in fact 6.9 IQ points?

Do you concede that the 27 Chinese studies reviewed by Choi, et al, were so seriously flawed that Choi and Grandjean were led to issue a statement that distanced these studies from comparison with fluoridated water in the United States? Do you concede that these 27 studies were so seriously flawed that nothing of any significance could be concluded from them?

If not, let me refresh your memory with some of the problems noted by Choi, et al. In their Harvard Review of these studies.

“The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.”

Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.

Page 9

“Six of the 34 studies identified were excluded due to missing information on the number of subjects or the mean and variance of the outcome (see Figure 1 for a study selection flow chart and Supplemental Material, Table S1 for additional information on studies that were excluded from the analysis). ”

Page 13

“Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.”

Once again, note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration, exactly in the range of the control groups in this study.

Page 13-14

“While most reports were fairly brief and complete information on covariates was not available, the results tended to support the potential for fluoride-mediated developmental neurotoxicity at relatively high levels of exposure in some studies.”

Incomplete information on covariates (controls). Relatively HIGH levels of fluoride. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.

Page 15

“The present study cannot be used to derive an exposure limit, as the actual exposures of the individual children are not known. Misclassification of children in both high- and low-exposure groups may have occurred if the children were drinking water from other sources (e.g., at school or in the field).”

Page 15-16

“Still, each of the articles reviewed had deficiencies, in some cases rather serious, which limit the conclusions that can be drawn. However, most deficiencies relate to the reporting, where key information was missing. The fact that some aspects of the study were not reported limits the extent to which the available reports allow a firm conclusion. Some methodological
limitations were also noted. Most studies were cross-sectional, but this study design would seem appropriate in a stable population where water supplies and fluoride concentrations have remained unchanged for many years. The current water-fluoride level likely also reflects past developmental exposures. In regard to the outcomes, the inverse association persisted between studies using different intelligence tests, although most studies did not report age adjustment of the cognitive test scores.”

Kane, the section of the Royal Society Report dealing with neurotoxicity actually says:

Setting aside the methodological failings of these studies, Choi et al. determined that the standardised weighted mean difference in IQ scores between “exposed” and reference populations was only -0.45. The authors themselves note that this difference is so small that it “may be within the measurement error of IQ testing”.[172]

What do you find wrong with that?

After all, this is what Choi et al (2012) actually said:

“The estimated decrease in average IQ associated with fluoride exposure based on our analysis may seem small and may be within the measurement error of IQ testing.”

Also, I find it interesting that you are carefully avoiding any comment on my post. I presume you cannot find anything wrong with it so wish to avoid it?

What do you find wrong with that?…
…Kane, what are your comments on…
…I would also be interested in your comments on…

Hmm,no disrespect Ken as I know you are making a point about Kane’s obfuscation, but really, who the hell cares what “Kane” has to say about anything.

Better the intelligent, rational approach of heeding the position statements re fluoridation from CDC, Surgeon General, Royal Society, WHO, and every single medical, dental and scientific community in the world.

This review claims it shows children in fluoridated areas had about half the decay rates of those in unfluoridated areas.
In fact this was a very weak study, whose conclusions are not supported by the results presented. Children were examined in a mobile clinic and the teeth were not cleaned or dried for the examination.
Due to the small numbers, results were not statistically significant, and many
confounding factors were uncontrolled.
In fact, the authors admit in the discussion that “there were no significant differences in deciduous caries prevalence or severity (or in the permanent caries prevalence) by socio-demographic characteristics or length of residence in fluoridated areas.” (Page 31 of the Critique)

In their 2005 paper “Enamel defects and dental caries among Southland children”,
Thomson (a panel member of this present review) et al report:
“There were no significant differences in deciduous caries prevalence or severity (or in permanent caries prevalence) by socio-demographic characteristics or length of residence in fluoridated areas”
This is, in fact, what their research showed, however they oddly concluded that decay rates were halved by CWF. (Page 33 of the Critique)

I’d also like you to answer this question as well please. The 2009 Oral Health Survey was in the NZ Review.

“Overall, children and adults living in fluoridated areas had significantly lower
lifetime experience of dental decay (ie, lower dmft/DMFT) than those in non-fluoridated areas”. (Page 71 of the NZ Fluoridation Review).

However the 2009 Oral Health Survey includes this statement:

“It is important to note that it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be considered a fluoridation study as such. The following results are for a snapshot in time and constitute an ecological analysis based on current place of residence. As such, they do not take into consideration lifetime exposure to fluoridated and nonfluoridated water supplies. Individuals who currently live in fluoridated areas may have spent time in non-fluoridated areas, and the reverse is also true. Furthermore, there may be other confounding facts that have not been taken into consideration.” Our Oral Health Page 167.

Given the above statement in Oral Health report do you believe that it was disingenuous for DHBs to use the 40% tooth decay reduction figure from the 2009 Oral Health Survey for the difference between fluoridated and nonfluoridated areas?

As you will be aware this was a key plank of the 2013 referenda in Whakatane, Hastings and Hamilton.

Have you actually read the paper? Did someone tell you that it was a weak study, or have you actually read it? Look at Table VI – the Poisson regression model for DMFS shows that those with continuous residence in fluoridated areas up to age 9 had, on average, half the accumulated dental caries experience of those who had lived none of their lives in an area with CWF – after controlling for the confounders of sex, ethnicity and socio-economic status. BTW, children were NOT examined in mobile clinics (not that that should make a difference in field epidemiology). As for the assertion that it was under-powered, the statistical significance of the observed differences contradicts it.

I think that one of the problems with our anti-CWF people is that very few of them have had any actual field experience in conducting research or in writing it up for publication – it is, of course, far easier to sit and criticise than it is to get out there and do it.

I think my critique of the article makes clear that Stan has indulged in a lot of cherry-picking and misrepresentation. I have dealt with some of it in my post – your studied ignoring of my post suggests you actually cannot refute any of my points.

So it is incumbent on you to check very closely any of Stan’s assertions – to never accept them at face value.

There is so much wrong with Stan’s article that I just did not have the space to deal with each point – especially as he has made most of them in passing without evidence or argument.

If you are not prepared to check out Stan’s claims yourself (and you have so far refused to) then it is a waste of time to ask others to do this for you. You should at least read the paper you are referring to and quote the sections which you claim are contradictory.

Q. How much difference does having the fluoride in water topped up make?

A lot. The most recent NZ study shows on average 40% less tooth decay for children in fluoridated areas compared to those areas without it New Zealand Oral Health Survey, Ministry of Health, 2009. Many other studies have shown that children and adults living in areas with community water fluoridation have significantly lower tooth decay than people living in areas without it.

The 2009 Oral Health Survey clearly states:

“It is important to note that it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be considered a fluoridation study as such. The following results are for a snapshot in time and constitute an ecological analysis based on current place of residence. As such, they do not take into consideration lifetime exposure to fluoridated and nonfluoridated water supplies. Individuals who currently live in fluoridated areas may have spent time in non-fluoridated areas, and the reverse is also true. Furthermore, there may be other confounding facts that have not been taken into consideration.” Our Oral Health Page 167.

I’m asking the panel member who contributed to the Royal Society Review to substantiate his comments. I didn’t write the critique or review it.
I’ll wait for Murray to respond to my question about the 2009 Oral Health Survey.

Oh, Stan has been asked. He has been offered space for an exchange along the lines of the exchange with Paul Connett. He has been invited to comment. His silence is very telling.

You didn’t write the critique or review it but like all the authors and reviewers you are an anti-fluoride propagandist belonging to an anti-fluoride activists organisation. In fact you are one of the leaders of the Fluoride Free NZ group which is responsible for putting the document described in is post together.

You refusal to support the document is very telling.

If you guys refuse to support your won documents or take any responsibility for them what credibility can you have.

Your question about the Oral Health Survey is one you commonly ask of people. It is in essence exactly the same question I am asking of you.

Normally when this is turned back in you on Facebook you run away and delete all your comments.myiu don’t have that ability here. Your refusal to discuss this issue is on record and remain as in record.

Kane Titchener, one of the Auckland area and campaign contacts for Fluoride Free NZ refuses to support his organisation’s documents, is in fact embarrassed by them!

Certainly. Colgate funds a Senior Lectureship in Periodontology (and in case you don’t know what that is, it’s the science of investigating, treating and preventing disorders of the supporting tissues of the teeth [“gums”]). It has funded that position since the mid-1990s, as far as I am aware.

5 minutes into that presentation you said that 94% of dentists support fluoridation. I checked with David Crum and he said that this 94% comes from Grant et al study 2013 NZDJ. Is that correct?

Given the low turn out in responses 465 dentists would you not consider this survey to be too statistically insignificant to be able to categorically make the claim?

Within that survey did you supply basic information to Dentists like the source of fluoride chemical that is added to the water supply?

I only ask because at the recent presentation in Taupo a number of the dentists in the audience were unaware that the fluoride chemical was sourced from the fertiliser industry. I genuinely believe that they didn’t know this basic fact. Is the source of fluoride chemicals discussed anywhere at Dental School?

Why then do you say in the Southland study discussion that “there were no significant differences in deciduous caries prevalence or severity (or in the permanent caries prevalence) by socio-demographic characteristics or length of residence in fluoridated areas.”

OK, clearly you are being deliberately obtuse. The issue with the 94% estimate is the degree to which nonresponders differ systematically from responders in terms of their sociodemographic characteristics. We were able to show that our sample was most likely representative by virtue of its being pretty similar to the wider dentist population. Now, turning to the Mackay and Thomson paper, what you need to understand is the difference between caries prevalence and caries severity (aka caries experience). The DMF score represents the latter; it is NOT a measure of caries prevalence. The prevalence of caries is the proportion of the population with 1 or more DMF. Remember also that we make our way through two dentitions during the life course, with the deciduous (baby) teeth gradually replaced by the permanent (adult) teeth from ages 6 through to about 12-13 or so, depending on maturity. Now that you understand that (or, at least, I hope you do), you can read those data and be able to interpret the data. I am not going to do it for you. I am now signing off.

It would be good to get your view on the 2009 Oral Health Survey and then that will be it.

The 2009 Oral Health Survey clearly states:

“It is important to note that it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be considered a fluoridation study as such. The following results are for a snapshot in time and constitute an ecological analysis based on current place of residence. As such, they do not take into consideration lifetime exposure to fluoridated and nonfluoridated water supplies. Individuals who currently live in fluoridated areas may have spent time in non-fluoridated areas, and the reverse is also true. Furthermore, there may be other confounding facts that have not been taken into consideration.” Our Oral Health Page 167.

You really have no idea as to what is actually ingested as a result of water fluoridation, have you? From your comments, it’s obvious that you don’t, but just thought I would give you a chance to demonstrate at least an elementary understanding of this public health initiative about which you emit such volumes of hot air.

“Of course. The Ministry put that disclaimer into the national survey report because it is a reasonable caveat. Nevertheless, national-level data from calibrated examiners in a systematically conducted survey are scarce in NZ because it is very difficult to get funding for and run a national survey. Those who collect the data have an ethical obligation to get as much information as possible out of it (because a lot of resources have gone into collecting the information and a lot of NZers have been inconvenienced by taking part), but they are careful to add such caveats. The national survey was conducted to provide a snapshot of oral health and disease in 2009, but that does not preclude other investigations using the same data – it’s called secondary data analysis and is a legitimate investigative strategy.”

I have appreciated Murray Thomson spending the time to respond to my questions.

“No ad hominem”?? The above dissertation defines ad hominem attack.
Two excellent books about water fluoridation are “The Fluoride Deception” (2004), by Christopher Bryson , and “Fluoridation: The Great Dilemma” (1978) by George L. Waldbott, M.D.
I read both of these after I realized what fluoridation chemicals are adding to the otherwise purified drinking water. As a senior engineer at a municipal water utility serving a municipality of about a half-million people, I was tasked with preparing the technical specifications for the fluorosilicic acid (FSA) purchasing contract. A Certificate of Analysis (CofA) was required to accompany each tanker truckload of FSA upon delivery. Reviewing previous and subsequent CofAs over several years of deliveries, I saw arsenic concentrations in every shipment, typically ranging from 25 – 50 mg/L. Arsenic is invariably added to the drinking water in measurable concentrations as a normally occurring contaminant in FSA. The EPA has determined the Maximum Contaminant Level Goal (MCLG) for arsenic is zero. By EPA’s definition, “The MCLG is the maximum level of a contaminant in drinking water at which no known or anticipated adverse effect on the health of persons would occur, allowing an adequate margin of safety.”
In my opinion, as a P.E. and licensed treatment plant operator, with more than 20 years of water resources engineering in the public sector, knowingly adding a heavy metal carcinogen with an MCLG of zero is a violation of not only the spirit and intent of the federal Safe Drinking Water Act, but also the public trust.

John, it’s not clear why you are commenting here on an old post unrelated to the contamination issue.

However, you need to put into context the concentration of arsenic and other contaminants in water treatment chemicals with the amounts already in the source water. We can analyse anything for heavy metals at very low concentrations – so it is easy to scaremonger with such information.
Have a read of my article Chemophobic scaremongering: Much ado about absolutely nothing. This calculates the contribution contaminants in treatment chemicals make to your drinking water and compares it with the contribution from the original water itself.

In fact, the contribution from the “pure” source water is hundreds of times greater than that from fluoridating chemicals.

If you are upset about such contamination you should be protesting about the source water itself.

If nothing else, this issue does bring out how uninformed some water treatment personnel truly are. Given that these folks are responsible for keeping our drinking water safe, it is scary to see someone like John admit to relying on conspiracy books rather than the peer-reviewed science.